Smokers Say E-Cigs Are Just 'Cooler' than Other Inhalers

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Nicotine inhalers, which are devices similar to electronic
cigarettes, have existed for years, but they were just not cool
enough to catch on, researchers say.

Listed among the treatments used for helping smokers quit,
nicotine inhalers were approved by the Food and Drug
Administration (FDA) in 1997. The devices deliver nicotine to the
mouth when the smoker puffs at the plastic mouthpiece that looks
like an old-fashioned cigarette holder.

"It's remarkable how these products have been around for over 15
years now, and physicians and consumers are not aware of them,"
said Dr. Michael Steinberg, an internist at Rutgers, The State
University of New Jersey, who runs a tobacco treatment program.
[ Kick
the Habit: 10 Scientific Quit-Smoking Tips ]

E-cigarettes work by vaporizing a nicotine-containing solution.
Studies on the effectiveness of these devices in helping smokers
quit have yielded
mixed results. Nevertheless, the devices seem to have gained
increasing popularity among smokers who wish to quit, or are
merely looking for a replacement to traditional cigarettes, and
some have claimed they are particularly appealing to young
people.

To compare how users perceive nicotine inhalers compared with the
fancier e-cigarettes, Steinberg and colleagues gave 40 smokers
both devices to use, for three days each, and asked them to
report their experience.

The results showed the e-cigarette received higher ratings for
helpfulness, acceptability and "coolness," according to the
study, published in the Journal of General Internal Medicine in
May.

"E-cigarettes consistently scored higher than the inhaler in
things like satisfaction, psychological reward, acceptability and
cooler image," Steinberg said. "Despite the lack of evidence
regarding the safety and effectiveness of e-cigarettes, over
three-quarter of participants said they would use e-cigarettes to
help them quit smoking, compared to less than one-quarter for
the product that's FDA-approved to do that."

Some of the differences between the devices may due to their
marketing, the researchers said. E-cigarettes are widely
advertised. Inhalers on the other hand, haven't had the same type
of marketing effort, Steinberg said.

"We can learn to take some of this information as to what makes
e-cigarettes appealing, and if we can apply that to the safe,
proven treatments that we have, that would be wonderful," he told
Live Science.

But aside from being viewed as less cool, another reason that
might explain why inhalers haven't been used as much as
e-cigarettes is that people need a prescription to get an
inhaler.

"It certainly could be a barrier to access," Steinberg said.
However, "in our studies we gave the products to folks free of
charge, so their access is equal. And how much the participants
liked the e-cigarettes over the inhalers is dramatic."

Compared to inhalers, e-cigarettes are heavier, and the vapor
they produce better mimics the smoking experience. However, as
the devices are not regulated, the amount of nicotine delivered
by e-cigarettes varies
widely, Steinberg said. Some e-cigarettes contain no nicotine
at all and some can deliver nicotine at levels two or three times
greater than what is delivered in other nicotine replacement
therapies.

"You can buy e-cigarettes and have no idea how much nicotine
you're getting into your body," Steinberg said.

In the study, 18 percent of participants did not smoke during the
three-day test period using the e-cigarette, whereas 10 percent
of participants refrained while using the inhaler.

"If e-cigarettes are what's going to be dominating the tobacco
market in decades to come, we need to be able to demonstrate that
even though these are appealing and popular products, they are
safe to use," Steinberg said. "If they can be regulated so they
are safe products, we can take advantage of their popularity and
their appeal and use them as a harm-reduction nicotine-delivering
device."